Comparative evaluation of the effect of Er:YAG laser and low level laser irradiation combined with CPP-ACPF cream on treatment of enamel caries

Abstract

Objectives: This study investigated the effectiveness of low power red and infrared lasers and that of Er:YAG laser, in association with CPP-ACPF cream, on remineralization of white spot lesions. Study Design: Fifty intact premolars were immersed in a demineralization solution for 10 weeks to induce caries like lesions and then were divided into five groups. In group 1, the teeth were covered with a CPP-ACPF cream for 3 minutes and then irradiated with a low power red laser (660 nm, 200 mW) for 1 minute through the cream. In group 2, the treatment was the same as that in group 1, but an infrared laser (810 nm, 200 mW) was employed. The specimens in group 3 were irradiated with an Er:YAG laser (100 mJ, 10 Hz) combined with CPP-ACPF. In group 4, the CPP-ACPF cream was applied for 4 minutes and group 5 was submitted to neither laser nor CPP-ACPF. The micro Vickers hardness was compared at 20, 60 and 100 µ from the enamel surface among the groups. Results: The highest microhardness was observed in the low power red and Er:YAG laser groups and the lowest one belonged to the CPP-ACPF alone and control groups. However, no significant difference was found in microhardness of the experimental groups at any of the evaluation depths (p>0.05). Conclusions: With the laser parameters used in this study, neither the combined application of Er:YAG laser with CPP-ACPF nor the combination of low power lasers with CPP-ACPF provided a significant increase in remineralization of enamel caries. Key words:Low level laser, Er:YAG, laser, enamel caries, CPP-ACP, microhardness, white spot lesion.

The Effects of Remineralization via Fluoride Versus Low-Level Laser IR810 and Fluoride Agents on the Mineralization and Microhardness of Bovine Dental Enamel

“…The average microhardness of the control and laser groups had a similar remineralizing effect, which contradicts other studies that show that low-power lasers create a harder and more resistant surface than the additional calcium compounds or the control group [12,14]. The group with the best microhardness was fluoride, although the rate of application and fluoride content for all groups was the same (22,600 ppm).…”

“…Moreover, the effects are higher when fluoride-or calcium-based compounds are irradiated concurrently [11][12][13][14]17]. Nevertheless, the data show that the mineral content of the laser group was similar to the control.…”

“…These lasers absorb water from the hydroxyapatite of tooth tissues and can modify the crystalline structure, acid solubility, and permeability of the tooth surface to increase resistance against demineralization. However, high-power lasers are costly and not readily available in every practice [11][12][13][14].…”

Structural and Morphological Changes in Human Dentin after Ablative and Subablative Er:YAG Laser Irradiation

“…1,25 The heat produced during laser irradiation leads to vaporization, oxidation of organic components, transformation of acid phosphate to pyrophosphate, and reduction of carbonate content. 3,4,25,26 These changes result in the formation of more stable and less soluble components, which might increase the resistance of irradiated substrate against demineralization.…”

“…1,2 The growing sugar consumption and the inadequate oral hygiene are considered as the main reasons for the high incidence of dental caries. These factors may also contribute to the formation of secondary caries around restorations.…”